I'm a medical doctor and NHS psychiatrist. AMA

[DoctorDr]

NHS pyschiatry (inpatient) with several years experience. Please ask away :)

Do you feel supported by Headship? Do you feel you can care for your patients well?

Is there a link between Autism and Epilepsy? We have several autistic family members who also have epilepsy could they linked or is it just in our genetics?

Yes absolutely. Very strong and well-documented link. 10x higher risk than the general population

The short answer is, within the NHS, no and no unfortunately. Patients generally don't receive the best care possible - mostly due to abysmal funding and very poor staff retention.

I recently had a relative who was receiving in patient psychiatric care. She has had such care in the past; this was the latest time she has been committed (apologies if that's outdated terminology)

One thing that myself and some other family members couldn't understand is that she was allowed access to her mobile phone. So, she continued sending hysterical communications to friends and family and insisting on being religiously updated about various life stresses.

Why are patients not refused access to mobile phones/social media etc when it's clearly so strongly linked to stress?

Do you ever come across true psychopaths who frighten you? What happens to them and can they be medicated or do they have to be locked up

How do you feel about patients with a BPD diagnosis?

Hi. Really sorry to hear that and it's an ongoing struggle on our ward too. In fact I feel like the majority of people's issues (outside of severe mental illness) would resolve if their phone was taken for 6 months.

When you say comitted, was she definitely comitted? (Under section / sectioned) . Usually we try to aim for them to be in hospital voluntarily if possible. If they're voluntary we can't just take phones away as we'd have no legal grounds to do that.

If she was under section, then it is technically possible, but usually very hard to justify. When we section someone, everything has to be done according to the "least restrictive principle" which is to treat whilst restricting as few liberties as possible. Taking the phone away can be tricky under least restrictive principle. Most patients also need their phone to communicate with mental health advocates, solicitors, family, loved ones, make sure someone's looking after the house or pets or kids etc. If we were caught taking phones away, and the daily mail got hold of that, could you imagine what narrative could be spun that we're sectioning people and taking their phones away so they can't tell anyone about it? etc.

So yeah, very challenging unfortunately but completely agree they are usually doing far more harm than good from a social media / groupchat POV. We even have a large group of local EUPD women trying to get admitted at the same time in the same hospitals so they can be on the ward together

I felt like they didn't believe a word I said. So I just started telling them what they wanted to hear. So for some conditions I think they almost force you to lie. Your instinct is to want to get out as quickly as possible but you're not allowed to express that.

Not really, no. My hospital is only medium security, so anyone who is a "true psychopath" (which in itself is debated as to whether that even exists or is just a hollywood trope) would be in a high security hospital like broadmoor, which I have no experience with unfortunately! I did meet a few ice-cold, manipulative, remorseless and severely dangerous patients on a medical student placement - but they were pedophiles, not murderers, if that counts

Do you mean Borderline Personality Disorder (EUPD) or BiPolar Disorder? Both often called BPD

Do you think more people could do more to help themselves in terms of mental health?

Do you think our current society causes a lot of mental distress that could be avoided if we reconfigured our culture (I know that's not a realistic possibility!), or would the people you see still be in the same position regardless of what kind of society they lived in?

Also what do you think of the massive increase in people who say they have anxiety etc in recent years?

Does your job impact on how you see the world? How do you look after yourself?

My dd is autistic and in sertraline 100mgs propanolol 70mgs split doses and Clonidine 1/4 of 0.1 mgs. She has responded to the clonidine and propanolol well I think. It’s subtle but she isn’t over thinking as much as she has been on sertraline varied doses for 3 years now and I feel it’s not doing a lot. She also has pots. Is there a better fit for her? She has emetophobia. OCD over food.
anxiety about feeling unwell when out. Her autism
means therapy isn’t as effective She sees her therapist every two weeks on zoom. Who she Ja s good relationship with.
it’s getting frustrating as she is very bright and wants to do tho g with her life. Thank you

Would you be comfortable prescribing a SSRI to a 14 year old? Particularly if there was no therapy undertaken in conjunction?

Why are neurology and psychiatry so seperate and where is the line. It makes absolutely no sense to me that psychiatry and neurology are not the same speciality and yet both of them are entirely focused on the same organ. I think the right hand should be speaking to the left and psychiatry should be far more neurology focused because at the moment diagnosis are so behaviourally focussed which affects it’s credibility.

Borderline personality disorder

How did you get into this line of work? DD is very keen on studying psychology at uni with the ultimate aim of going into clinical psychology or psychiatry..

Do psychiatrists earn very well? An ex-colleague gave up a good career to become a full-time dad to school age children. His wife is a psychiatrist (very experienced, mid-40s).

I was really surprised by that, so I was wondering if he came into some money or just that his wife is very handsomely paid.

Are you qualified to diagnose autism and/or ADHD? Are you of the same thinking as many of the general public that the diagnostic criteria are too broad so too many people are getting diagnosed? Or do you think that the criteria have broadened due to the increased understanding of both conditions and thank goodness more people are potentially getting the support they need?

Psychiatry is a medical speciality for doctors who have been to medical school and can prescribe / section patients etc. Not accesible by psychology at uni unfortunately. Obviously there is the path of medical school but that's a wholy different question.

When I was 19 I was given the label Inadequate Personality. I wasn't told about it, just happened to see this on my GP's computer screen. I was very shy and depressed at the time, but what a horrible label to have. Is this label still used, and if it is, what does it mean please?

What do you think about ECT as a treatment?